Abstract
STATEMENT OF THE PROBLEM: The application of digital impressions for complete-arch implant supported fixed dental prostheses (FDP) remains controversial, and data from a systematic review with meta-analysis comparing intraoral scanning (IOS) and stereophotogrammetry (SPG) remain limited. PURPOSE: To evaluate and compare the accuracy of currently available digital technologies, specifically IOS and SPG, in capturing complete-arch implant impressions. MATERIALS AND METHODS: An electronic and manual search was conducted on May 4, 2024, across PubMed, Embase, and Cochrane CENTRAL databases following PRISMA guidelines. The search targeted studies (excluding case reports) that assessed the in vivo, in vitro, or ex vivo accuracy of IOS and SPG for complete-arch implant impressions. Two investigators screened eligible studies using the QUADAS-2 tool. Accuracy was the primary outcome, including linear, angular, surface deviations, and inter-implant distance. Three meta-analyses were performed on angular deviations, trueness, and surface deviations, trueness, and precision using a random-effect model. RESULTS: Thirteen studies (3 in vivo and 10 in vitro) met inclusion criteria, displaying methodological heterogeneity (8 analyzing surface, 3 linear, 8 angular, and 3 interimplant distance deviations). The studies evaluated seven IOS (Aoralscan 3, Carestream 3600, iTero Element 2, iTero Element 5D, Primescan, Trios 3, and Trios 4) and two SPG devices (PIC and ICam4D). The number of implants ranged from 4 to 8. SPG reported higher accuracy than IOS in 10 of 13 studies. One in vitro study found IOS to have higher trueness but lower precision, another in vitro study found higher accuracy with IOS, and one in vivo study showed comparable trueness. Meta-analyses of in vitro studies revealed significant differences favoring SPG in surface deviation trueness and precision, and angular deviation trueness (p < 0.05), with reported effects of 3.426, 4.893, and 1.199. SPG showed surface trueness and precision, and angular trueness mean ranges 5.18-48.74 and 0.10-5.46 μm, and 0.24°-0.80°, while IOS ranges 14.8-67.72 and 3.90-37.07 μm, and 0.28°-1.74°. CONCLUSIONS: Within study limitations, SPG showed to be a more reliable technology than IOS for complete-arch digital implant impression, exhibiting significantly greater trueness and precision. IOS reported an angular deviation exceeding the 1° threshold required for a passive fit. Further clinical trials are required for conclusive evidence. Until then, a rigid prototype try-in is still recommended. TRIAL REGISTRATION: CRD42024490844.